Effects of Short-Term Corticosteroid Use on Reactogenicity and Immunogenicity of the First Dose of ChAdOx1 nCoV-19 Vaccine

단기 코르티코스테로이드 사용이 ChAdOx1 nCoV-19 백신의 첫 번째 용량의 반응성 및 면역원성에 미치는 영향

Published on
Journal: Frontiers in Immunology
[저자] Jinyoung Yang, Jae-Hoon Ko, Jin Yang Baek, Jinyeong Hong, Soyoung Ha, Beomki Lee, Kyungmin Huh, Sun Young Cho, Cheol-In Kang, Doo Ryeon Chung, Yae-Jean Kim, Eun-Suk Kang, Kyong Ran Peck
[Category] SARS, 진단,
PMC URL    [DOI] 10.3389/fimmu.2021.744206    
[Article Type] Comparative Study
[Source] PMC

The effects of corticosteroid use on the reactogenicity and immunogenicity of ChAdOx1 nCoV-19 (ChAd) vaccine were evaluated. Healthcare workers (HCWs) who took low-dose corticosteroid agents around the time of the first dose of ChAd (ChAdPd group) were recruited and the reactogenicity and immunogenicity were compared with those of ChAd (ChAd group) and BNT162b2 vaccination (BNT group) of HCWs without corticosteroid exposure. The immunogenicity was measured three weeks after vaccination using quantitative anti-SARS-CoV-2 spike protein (S) antibody electrochemiluminescence immunoassay and interferon gamma (IFN-γ) release assay. A total of 67 HCWs comprising 24 ChAd, 29 BNT, and 14 ChAdPd was included. The median total corticosteroid dose of the ChAdPd group was 30 mg prednisolone equivalents (interquartile range (IQR) 20–71.3 mg). HCWs in the ChAdPd group experienced significantly milder reactogenicity (median total score 7.5, IQR 4.0–18.0) compared to those in the ChAd group (median 23.0, IQR 8.0–43.0, P =0.012) but similar to that in the BNT group (median 5.0, IQR 3.0–9.0, P =0.067). The S antibody concentration of the ChAdPd group (62.4 ± 70.0 U/mL) was higher than that of the ChAd group, though without statistical significance (3.45 ± 57.6 U/mL, P =0.192). The cellular immune response was most robust in the ChAdPd group, with significantly higher IFN-γ concentration (5.363 ± 4.276 IU/mL), compared to the ChAd (0.978 ± 1.181 IU/mL, P =0.002) and BNT (1.656 ± 1.925 IU/mL, P =0.009) groups. This finding suggest that short-term corticosteroid reduces reactogenicity of the first dose of ChAd without hindering immunogenicity.

All Keywords
【저자키워드】 COVID-19, Vaccine, immunogenicity, reactogenicity, steroid, 【초록키워드】 Corticosteroid, vaccination, antibody, Cellular immune response, anti-SARS-CoV-2, healthcare worker, Spike protein, BNT162b2, HCWs, Quantitative, ChAdOx1 nCoV-19, IFN-γ, interferon gamma, Concentration, dose, HCW, interquartile range, low-dose corticosteroid, first dose, statistical significance, total score, electrochemiluminescence immunoassay, Effect, robust, was measured, significantly, recruited, evaluated, median, significantly higher, reduce, groups, BNT, IQR, prednisolone equivalent, 【제목키워드】 ChAdOx1 nCoV-19, Effect,
ChAdOx1 nCoV-19(ChAd) 백신의 반응원성과 면역원성에 대한 코르티코스테로이드 사용의 영향을 평가했습니다. ChAd(ChAdPd군)의 첫 접종 시점에 저용량 코르티코스테로이드제를 복용한 의료인(HCW)을 모집하여 ChAd(ChAd군) 및 BNT162b2 백신접종(BNT군)과 반응원성 및 면역원성을 비교하였다. 코르티코스테로이드에 노출되지 않은 HCW. 면역원성은 정량적 항-SARS-CoV-2 스파이크 단백질(S) 항체 전기화학발광 면역분석 및 인터페론 감마(IFN-γ) 방출 분석을 사용하여 백신 접종 3주 후에 측정되었습니다. 24개의 ChAd, 29개의 BNT 및 14개의 ChAdPd로 구성된 총 67개의 HCW가 포함되었습니다. ChAdPd 그룹의 총 코르티코스테로이드 용량 중앙값은 30mg 프레드니솔론 등가물이었습니다(사분위수 범위(IQR) 20-71.3mg). ChAdPd 그룹의 HCW는 ChAd 그룹(중앙값 23.0, IQR 8.0–43.0, P = 0.012)에 비해 상당히 약한 반응성(총 점수 중앙값 7.5, IQR 4.0–18.0)을 경험했지만 BNT 그룹(중앙값 5.0, IQR 3.0–9.0, P = 0.067). ChAdPd 그룹의 S 항체 농도(62.4 ± 70.0 U/mL)는 ChAd 그룹보다 높았지만 통계적 유의성은 없었습니다(3.45 ± 57.6 U/mL, P = 0.192). 세포 면역 반응은 ChAd(0.978 ± 1.181 IU/mL, P = 0.002) 및 BNT(1.656 ± 1.925)에 비해 ChAdPd 그룹에서 유의하게 더 높은 IFN-γ 농도(5.363 ± 4.276 IU/mL)로 가장 강력했습니다. IU/mL, P = 0.009) 그룹. 이 발견은 단기 코르티코스테로이드가 면역원성을 방해하지 않고 ChAd의 첫 번째 용량의 반응성을 감소시킨다는 것을 시사합니다.